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Novel diagnostic tool PLUS accurate for detecting acute pneumonia in elderly adults

12 Sep 2020

A novel diagnostic tool, called the Pneumonia Lung Ultrasound Score (PLUS), is an easy, biomarker-derived, and accurate method for detecting acute pneumonia in the very old, a recent study has found.

Researchers conducted a prospective, single-centre cohort analysis of 132 elderly adults (mean age, 85.3±6.9 years; 69 percent female) who underwent chest X rays (CXR) and lung ultrasound (LUS). PLUS was defined as LUS with biomarkers such as the brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP), and partial pressure arterial oxygen/fraction of inspired oxygen ratio (PaO2/FIO2).

LUS emerged as a better diagnostic tool than CXR, particularly in patients with multidimensional prognostic index (MPI) scores 0.33–0.66 (diagnostic accuracy, 0.97 vs 0.72; p=0.04) and >0.66 (diagnostic accuracy, 1.00 vs 0.64; p=0.003). MPI is an indicator of short- and long-term mortality, as well as of frailty.

In turn, PLUS was significantly superior in detecting acute pneumonia relative to LUS (area under the curve [AUC], 0.92 vs 0.86; p=0.029) and CXR (AUC, 0.92 vs 0.67; p<0.0001). Removing BNP from the PLUS model slightly weakened its diagnostic value, though it remained significantly better than LUS (AUC, 0.91; p=0.039 vs LUS).

In the PLUS scheme, each 100-unit drop in PaO2/FIO2 was worth one point, as was each 10-ng/mL increase in hs-CRP. An increase in BNP of 500 pg/mL was worth –0.5 points. The risk of pneumonia increased by a factor of two with every 1-unit increase in the PLUS score (odds ratio, 2.26, 95 percent confidence interval, 1.71–2.99).

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Most Read Articles
21 Nov 2020
Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.
Elvira Manzano, 12 May 2020
After months of work disruption, profound worrying, social distancing, and isolation, SARS-CoV-2* still rages on, unyielding to human interventions.
Rachel Soon, 05 Dec 2020

The Malaysian National Immunisation Programme (NIP) will now include a hexavalent combination DTaP-IPV-HiB-HepB vaccine and a pneumococcal vaccine.

Elvira Manzano, 12 Dec 2020
Having asthma or allergy does not make COVID-19 severe, a new study presented at ACAAI 2020 has shown.